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Food allergies in children: adopt good practices

A little undercooked egg in her puree is what brought little Jade to the emergency room at Angers University Hospital.

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Food allergies in children: adopt good practices

A little undercooked egg in her puree is what brought little Jade to the emergency room at Angers University Hospital. The 6-month-old baby who presents with anaphylaxis (acute allergic reaction) is quickly treated and everything eventually returns to normal. The team of Dr Martine Morisset, allergist and head of the allergology unit of this hospital, therefore makes the diagnosis of egg allergy and recommends introducing other potential allergens very quickly into the child's diet. such as nuts, to prevent other allergies from setting in, but also small amounts of very cooked egg to speed up healing.

Six months later, Jade is back in hospital following an accidental consumption of hazelnuts. The parents, shocked by the first stay in the emergency room, had not followed the doctors' advice for fear of another violent reaction. Unfortunately, as Dr Morisset explains to us, “we missed the window of opportunity. Now it will be more difficult to desensitize her. We left for several years of treatment to “reverse” the phenomenon.”

In France, at the age of 5, 6% of children have at least one allergy as measured by Blandine de Lauzon-Guillain, epidemiologist, research director at INRAe, by studying the ELFE cohort, which follows closely of 18,000 children born in 2011. Milk is the main allergen (3.4%), followed by egg and peanut (1%). So, is it possible to avoid allergies? Not everyone, but good practices can be put in place. The scientist studied the introduction of 4 major food allergens: egg, milk, fish and wheat until the age of 10 months. It appears that for one in 10 children, at least two allergens had not been consumed at this age and that these children had a twice as high risk of food allergy.

From the start of dietary diversification, between 4 and 6 months, it is recommended to introduce all food groups, even those potentially allergenic, because the earlier children discover them, the more they develop a tolerance to these foods. Martine Morisset wants to be reassuring: most early childhood allergies will be able to heal naturally, this is particularly the case for eggs and milk. This is less true for peanuts and tree nuts. If the allergy persists, solutions exist, including specific immunotherapy. The principle is to repeatedly administer increasing doses of the allergen, at regular intervals, to modulate the immune response and increase the threshold of reactivity to ingestion of the food.

This was what was recommended for little Jade, allergic to egg, for whom immunotherapy began with the consumption of commercial biscuits containing egg cooked at very high temperature and in precisely known quantities. These immunotherapies must be started as early as possible. This desensitization generally works very well: 90% success for milk or eggs, but on the condition that the patient continues to consume the food.

The term intolerance, although widely used, is vague; we prefer to use the term hypersensitivity (allergic or not). For milk, for example, lactose intolerance corresponds to a deficiency in lactase, the enzyme which breaks it down and allows it to be digested well. If one is allergic, our immune system falsely recognizes these proteins as “aggressors,” and its response results in hives, asthma, and digestive problems.

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